Healthcare Provider Details

I. General information

NPI: 1215149018
Provider Name (Legal Business Name): PRIMARY EYECARE ASSOCIATES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/04/2007
Last Update Date: 06/25/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

93 ROBINHOOD LANE
TROY OH
45373
US

IV. Provider business mailing address

1086 FAIRINGTON DRIVE
SIDNEY OH
45365
US

V. Phone/Fax

Practice location:
  • Phone: 937-339-2115
  • Fax: 937-492-1901
Mailing address:
  • Phone: 937-492-9197
  • Fax: 937-492-1901

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number StateOH

VIII. Authorized Official

Name: DR. JEFFREY R AHRNS
Title or Position: PRESIDENT
Credential: O.D.
Phone: 937-492-9197